Effect of gastrin heptadecapeptide ( G 17 ) on cesophageal contractions in patients with diffuse cesophageal spasm

An intravenous bolus of pentagastrin significantly increased the amplitude and duration of cesophageal body contractions in seven patients with diffuse cesophageal spasm (DES) when compared with five normal subjects (p > 0-05). In order to determine whether this stimulation also occurred at physiological gastrin concentrations, the effect of an intravenous infusion of gastrin heptadecapeptide (G17), 25 pmol/kg-h, on cesophageal contractions was studied in DES patients. G17 had no significant effect on the amplitude and duration of cesophageal contractions compared with a saline control. This dose of G17 was near the D50 for gastric acid secretion and produced a rise in serum gastrin concentration comparable with a meal. G17 infusions at doses of 100 and 200 pmol/kg-h increased the amplitude and duration of cesophageal contractions, but the corresponding serum gastrin concentrations were higher than postprandial levels. Thus, endogenous fluctuations in serum gastrin heptadecapeptide, alone, are unlikely to alter cesophageal contractions in DES patients.